IDH mutation, 1p19q codeletion and ATRX loss in WHO grade II gliomas.

摘要: // Heather E. Leeper 1 , Alissa A. Caron 2 Paul Decker 3 Robert B. Jenkins 5 Daniel H. Lachance 4 Caterina Giannini Neuro-Oncology, Advocate Medical Group, Park Ridge, IL 60068, USA Experimental Pathology, Mayo Clinic SW, Rochester, MN 55905, Biomedical Statistics and Informatics, Neurology, Anatomic Correspondence to: Giannini, e-mail: giannini.caterina@mayo.edu Keywords: diffuse gliomas, WHO grade II, IDH mutation, ATRX, 1p19q codeletion Received: March 12, 2015      Accepted: June 22, Published: July 03, 2015 ABSTRACT Background: Epigenetic, genetic, molecular studies have identified several diagnostic prognostic markers in gliomas. Their importance for evaluating II gliomas has yet to be specifically delineated. Methods: We analyzed markers, including mutation(IDHmut), codeletion(1p19qcodel), ATRX expression loss(ATRX loss) p53 overexpression, outcomes 159 patients with oligodendroglioma, oligoastrocytoma, astrocytoma (2003–2012). Results: IDHmut was found 141(91%) loss 64(87%) of IDHmut-noncodel tumors ( p = 0.003). All codeleted n 66) were IDHmut. Four subgroups identified: IDHmut-codel, 66(43%); IDHmut-noncodel-ATRX loss, 60(39%); IDHmut-noncodel-ATRXwt, 9(6%); IDHwt, 14(9%). Median survival among groups significantly different 0.038), particularly IDHmut-codel (median 15.6 years) compared the remaining 0.025). Survival by histology not significant. Overall (OS), but progression-free (PFS), longer gross total resection vs. biopsy only 0.042). Outcomes subtotal from those only. Among these uniformly treated patients, OS far exceeds PFS, 1p/19q codeletion. Conclusions: For glioma, classification using 1p/19qcodel, IDHmut, more accurately predicts outcome should incorporated neuropathologic evaluation.